Alberts Adina, Lungescu Ioana Alexandra, Niculescu Adelina-Gabriela, Grumezescu Alexandru Mihai
Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.
National University of Science and Technology Politehnica Bucharest, 011061 Bucharest, Romania.
Pharmaceutics. 2025 Jun 8;17(6):758. doi: 10.3390/pharmaceutics17060758.
Scar development is a notable clinical and aesthetic issue in soft tissue healing, frequently compromising functionality and quality of life. Conventional treatments demonstrate limited efficacy in avoiding fibrosis and facilitating regenerative repair. Nevertheless, natural compounds have surfaced as viable alternatives owing to their biocompatibility, multitarget bioactivity, and historical application in traditional medicine. This review examines the therapeutic potential of plant-derived substances, marine agents, and microbial metabolites in influencing critical stages of wound healing, including inflammation, oxidative stress, fibroblast activation, and extracellular matrix remodeling. While these agents have demonstrated beneficial effects in preclinical models, their direct impact on functional or aesthetic clinical outcomes remains under investigation. We propose a hierarchical framework linking molecular mechanisms to clinical endpoints, suggesting that improvements at the cellular and molecular level may eventually support better healing quality. Natural bioactives, especially when integrated into advanced delivery systems such as hydrogels and nanocarriers, show promise for enhancing the regenerative microenvironment. By contextualizing these mechanisms within real-world therapeutic goals, this review highlights both the potential and limitations of natural products in the pursuit of improved soft tissue healing. Further translational research is needed to determine how modulation of these processes may reduce scarring and approach clinically meaningful outcomes.
瘢痕形成是软组织愈合中一个值得关注的临床和美学问题，常常影响功能和生活质量。传统治疗方法在避免纤维化和促进再生修复方面疗效有限。然而，天然化合物因其生物相容性、多靶点生物活性以及在传统医学中的长期应用，已成为可行的替代方案。本综述探讨了植物来源物质、海洋生物制剂和微生物代谢产物在影响伤口愈合关键阶段（包括炎症、氧化应激、成纤维细胞活化和细胞外基质重塑）的治疗潜力。虽然这些制剂在临床前模型中已显示出有益效果，但其对功能或美学临床结果的直接影响仍在研究中。我们提出了一个将分子机制与临床终点联系起来的分层框架，表明细胞和分子水平的改善最终可能有助于提高愈合质量。天然生物活性物质，特别是当整合到水凝胶和纳米载体等先进递送系统中时，有望改善再生微环境。通过将这些机制置于实际治疗目标的背景下，本综述强调了天然产物在改善软组织愈合方面的潜力和局限性。需要进一步的转化研究来确定如何调节这些过程以减少瘢痕形成并实现具有临床意义的结果。
